Background: Although small- and medium-sized hospitals comprise most healthcare providers in South Korea, data on antibiotic usage is limited in these facilities. We evaluated the pattern of antibiotic usage and its appropriateness in hospitals with <400 beds in South Korea. Methods: A multicenter retrospective study was conducted in 10 hospitals (6 long-term care hospitals, 3 acute-care hospitals, and 1 orthopedic hospital), with <400 beds in South Korea. We analyzed patterns of antibiotic prescription and their appropriateness in the participating hospitals. Data on the monthly antibiotic prescriptions and patient days for hospitalized patients were collected using electronic databases from each hospital. To avoid the effect of the COVID-19 pandemic, data were collected from January to December 2019. For the evaluation of the appropriateness of the prescription, 25 patients under antibiotic therapy were randomly selected at each hospital over 2 separate periods. Due to the heterogeneity of their characteristics, the orthopedics hospital was excluded from the analysis. The collected data were reviewed, and the appropriateness of antibiotic prescriptions was evaluated by 5 specialists in infectious diseases (adult and pediatric). Data from 2 hospitals were assigned to each specialist. The appropriateness of antibiotic prescriptions was evaluated from 3 aspects: route of administration, dose, and class. If the 3 aspects were ‘optimal,’ the prescription was considered ‘optimal.’ If only the route was ‘optimal,’ and the dose and/or class was ‘suboptimal,’ but not ‘inappropriate,’ it was considered ‘suboptimal.’ If even 1 aspect was ‘inappropriate,’ it was classified as ‘inappropriate.’ Results: The most commonly prescribed antibiotics in long-term care hospitals was fluoroquinolone, followed by β-lactam/β-lactamase inhibitor (antipseudomonal). In acute-care hospitals, these were third-generation cephalosporin, followed by first-generation cephalosporin and second-generation cephalosporin. The major antibiotics that were prescribed in the orthopedics hospital was first-generation cephalosporin. Only 2.3% of the antibiotics were administered inappropriately. In comparison, 15.3% of patients were prescribed an inappropriate dose. The proportion of inappropriate antibiotic prescriptions was 30.6% of the total antibiotic prescriptions. Conclusions: The antibiotic usage patterns vary between small- and medium-sized hospitals in South Korea. The proportion of inappropriate prescriptions exceeded 30% of the total antibiotic prescriptions.

Funding: None

Disclosures: None

This paper presents a modularized autonomous pipeline inspection robot called MRINSPECT VII+, which we recently developed. MRINSPECT VII+ is aimed at inspect in-service urban gas pipelines with a diameter of 200 mm. The robot consists of five basic modules: driving, sensing, joint, and battery modules. For nondestructive testing (NDT), an NDT module can be added to the system. The driving module uses a multiaxial differential gear mechanism to provide traction forces to the robot. The sensor module recognizes the pipeline element using position-sensitive detector (PSD) sensors and a CCD camera. The control module contains a computing unit and manages the robot’s autonomous navigation. The battery module supplies power to the system. Each module is connected via backdrivable active joint modules, which provide flexibility while moving inside narrow pipelines. Additionally, the wireless communication module helps the system communicate with the ground station. We tested MRINSPECT VII+ in real pipeline environments and validated its feasibility successfully.

Background: After the Middle East respiratory syndrome coronavirus outbreak in Korea in 2015, the government newly established the additional reimbursement for infection prevention to encourage infection control activities in the hospitals. The new policy was announced in December 2015 and was implemented in September 2016. We evaluated how infection control activities improved in hospitals after the change of government policy in Korea. Methods: Three cross-sectional surveys using the WHO Hand Hygiene Self-Assessment Framework (HHSAF) were conducted in 2013, 2015, and 2017. Using multivariable linear regression model including hospital characteristics, we analyzed the changes in total HHSAF scores according to the survey time. Results: In total, 32 hospitals participated in the survey in 2013, 52 in 2015, and 101 in 2017. The number of inpatient beds per infection control professionals decreased from 324 in 2013 to 303 in 2015 and 179 in 2017. Most hospitals were at intermediate or advanced levels of progress (90.6% in 2013, 86.6% in 2015, and 94.1% in 2017). In a multivariable linear regression model, the total HHSAF scores were significantly associated with hospital teaching status (β coefficient of major teaching hospital, 52.6; 95% CI, 8.9–96.4; P = .018), bed size (β coefficient of 100-bed increase, 5.1; 95% CI, 0.3–9.8; P = .038), and survey time (β coefficient of 2017 survey, 45.1; 95% CI, 19.3–70.9; P = .001). Conclusions: After the national policy implementation, the number of infection control professionals increased, and the promotion of hand hygiene activities was strengthened in Korean hospitals.

Funding: None

Disclosures: None

Spearman’s hypothesis tested at the subtest level of an IQ battery states that differences between races on the subtests of an IQ battery are a function of the g loadings of these subtests, such that there are small differences between races on subtests with low g loadings and large differences between races on subtests with high g loadings. Jensen (1998) stated that Spearman’s hypothesis is a law-like phenomenon. It has also been confirmed many times at the level of items of the Raven’s Progressive Matrices. This study hypothesizes that with concern to Spearman’s hypothesis, subtests and items function in fundamentally the same way, and tested whether Spearman’s hypothesis is confirmed at the item level for White–East Asian comparisons. A group of Korean young adults (N=205) was compared with other groups of young adults from Canada, the US, Russia, Peru and South Africa (total N=4770) who took the Advanced Progressive Matrices. Spearman’s hypothesis was strongly confirmed with a sample-size-weighted r with a value of 0.63. Computing the g loadings of the items of the Raven with either the Raven-g or the Wechsler-g led to the same conclusions. Tests of Spearman’s hypothesis yielded less-strong outcomes when the 36-item Advanced Progressive Matrices were used than when the 60-item Standard Progressive Matrices were used. There is a substantial correlation between sample size and the outcome of Spearman’s hypothesis. So, all four hypotheses were confirmed, showing that a part of the subtest-level nomological net replicates at the item level, strengthening the position that, with concern to Spearman’s hypothesis, subtests and items function fundamentally the same. It is concluded that Spearman’s hypothesis is still a law-like phenomenon. Detailed suggestions for follow-up research are made.

A 4.96-m-long sediment core from the Hanon paleo-maar in Jeju Island, Korea was studied to investigate the paleoclimatic change and East Asian monsoon variations during the latest Pleistocene to early Holocene (23,000–9000 cal yr BP). High-resolution TOC content, magnetic susceptibility, and major element composition data indicate that Jeju Island experienced the coldest climate around 18,000 cal yr BP, which corresponds to the last glacial maximum (LGM). Further, these multi-proxy data show an abrupt shift in climatic regime from cold and arid to warm and humid conditions at around 14,000 cal yr BP, which represents the commencement of the last major deglaciation. After the last major deglaciation, the TOC content decreased from 13,300 to 12,000 cal yr BP and from 11,500 to 9800 cal yr BP, thereby reflecting the weakening of the summer monsoon. The LGM in Jeju Island occurred later in comparison with the Chinese Loess Plateau. Such a disparity in climatic change events between central China and Jeju Island appears to be caused by the asynchrony between the coldest temperature event and the minimum precipitation event in central China and by the buffering effect of the Pacific Ocean.

This paper is the second report since 1984 on the photometric monitoring of long-period eclipsing binary stars at Yonsei University Observatory using a 61-cm reflector.

During the summer, from 1996–2000, vertical profiles of conductivity, temperature and transmissivity were obtained near the tidewater glacier of Marian Cove, King George Island, Antarctic Peninsula. The aims for the study were to determine the short-term variations of water structure due to hydrographic forcings and to understand sedimentation of suspended particulate matter in Antarctic fjord environments. Four distinct water layers were identified in the ice-proximal zone of the cove: i) a surface layer composed of cold and turbid meltwater, ii) a relatively warm Maxwell Bay inflow layer with characteristics of outer fjord water, iii) a turbid/cold mid-depth layer (40–70 m) originating from subglacial discharge, and iv) a deep layer comprised of the remnant winter water. The main factor influencing the characteristics of glacial meltwater layers and driving deposition of suspended particles in the cove is tidal forcing coupled with wind stress. The relatively small amount of meltwater discharge in Marian Cove yields low accumulation rates of non-biogenic sedimentary particles in the cove. The response to north-western and western winds, coupled with flood tide, may promote settling and sedimentation of suspended particles from turbid layers in the ice-proximal zone of the cove.

Yoon H-K, Kim Y-K, Han C, Ko Y-H, Lee H-J, Kwon D-Y, Kim L. Paliperidone in the treatment of delirium: results of a prospective open-label pilot trial.

Objective: Delirium is a life-threatening neuropsychiatric syndrome characterised by disturbances in consciousness, attention, cognition and perception. Antipsychotics are considered the drugs of choice in managing the symptoms of delirium. Paliperidone is a benzisoxazole derivative and the principal active metabolite of risperidone. In this study, we aimed to evaluate the efficacy of paliperidone for the treatment of delirium.

Methods: A prospective open-label study of paliperidone for delirium treatment was performed with 6-day follow-up. Fifteen patients who met Diagnostic and Statistical Manual of Mental disorders, Fourth Edition criteria for delirium and had a score of 13 on the Delirium Rating Scale were recruited. The starting dose was 3 mg once a day and the dose was adjusted depending on the status of delirium. Daily assessments of the severity of delirium were evaluated using Memorial Delirium Assessment Scale (MDAS).

Results: The mean daily maintenance dose of paliperidone was 3.75 ± 1.06. The MDAS scores before and after treatment (day 7) were 23.60 ± 6.31 and 11.33 ± 5.45 (t = 6.78, p < 0.001), respectively. The intensity of delirium showed a statistically significant reduction in MDAS scores from the first day of treatment. No serious adverse effects were observed, and none of the patients discontinued paliperidone because of adverse effects.

Conclusions: This study shows that low-dose paliperidone is effective in reducing behavioural disturbances and symptoms in delirium and is well tolerated in delirious patients. This trial is an open-label study with a small sample size, and further controlled studies will be necessary.

In this paper, human viscosity perception in haptic teleoperation systems is thoroughly analyzed. An accurate perception of viscoelastic environmental properties such as viscosity is a critical ability in several contexts, such as telesurgery, telerehabilitation, telemedicine, and soft-tissue interaction. We study and compare the ability to perceive viscosity from the standpoint of detection and discrimination using several relevant control methods for the teleoperator. The perception-based method, which was proposed by the authors to enhance the operator's kinesthetic perception, is compared with the conventional transparency-based control method for the teleoperation system. The fidelity-based method, which is a primary method among perception-centered control schemes in teleoperation, is also studied. We also examine the necessity and impact of the remote-site force information for each of the methods. The comparison is based on a series of psychophysical experiments measuring absolute threshold and just noticeable difference for all conditions. The results clearly show that the perception-based method enhances both detection and discrimination abilities compare with other control methods. The results further show that the fidelity-based method confers a better discrimination ability than the transparency-based method, although this is not true with respect to detection ability. In addition, we show that force information improves viscosity detection for all control methods, as predicted from previous theoretical analysis, but improves the discrimination threshold only for the perception-based method.

As one of the most important force production mechanisms of swimming and flying animals, the fluid dynamics of flapping has been intensively studied. However, these efforts have been mainly directed toward animals in forward motion or locomotive appendages undergoing linear translation. Here we seek to complement the existing knowledge of the flapping mechanism by studying angularly reciprocating flat plates without a free stream velocity, under a so-called ‘bollard pull’ condition. We visualize the flow field around the flat plate to find that two independent vortical structures are formed per half-cycle, resulting in the separation of two distinct vortex pairs at sharp edges rather than a single vortex loop which is typical of a starting–stopping vortex paradigm in flows with free streams. Based on our observations, we derive a scaling law to predict the thrust of the flapping plate; this is the first experimentally validated theoretical model for the thrust of angularly reciprocating plates without a prescribed background flow.

Using immunostaining methodology, we traced the axonal projection of FMRFamide (Phe-Met-Arg-Phe-NH2)-like immunoreactive (LI) medial neurosecretory cells (MNCs) and lateral neurosecretory cells (LNCs) from the brain into the ventral nerve cord (VNC) and retrocerebral complex in Bombyx mori (L.) (Lepidoptera: Bombycidae). Of the seven pairs of FMRFamide-LI MNCs, one pair extended its axons from the brain pars intercerebralis into the VNC ipsilateral connective where they appeared to terminate. The axons of the remaining MNCs ran through decussation in the brain median region and contralateral nervi corporis cardiaci (NCC) I out of the brain, and eventually innervated the contralateral corpus cardiacum (CC). Axons from the single pair of FMRFamide-LI LNCs projected into the ipsilateral NCC II fused with NCC I without decussation in the brain, and finally terminated in the CC. These results suggest that transport of the FMRFamide-like neuropeptide from may be related to the modulation of functions such as gut contraction in MNCs terminating in the VNC, and regulation of production and/or secretion of specific hormones such as juvenile hormone in MNCs and LNCs terminating in the CC.

Geochemical characteristics of marine sediment from the southern Drake Passage were analyzed to reconstruct variations in sediment provenance and transport paths during the late Quaternary. The 5.95 m gravity core used in this study records paleoenvironmental changes during the last approximately 600 ka. Down-core variations in trace element, rare earth element, and Nd and Sr isotopic compositions reveal that sediment provenance varied according to glacial cycles. During glacial periods, detrital sediments in the southern Drake Passage were mostly derived from the nearby South Shetland Islands and shelf sediments. In contrast, interglacial sediments are composed of mixed sediments, derived from both West Antarctica and East Antarctica. The East Antarctic provenance of the interglacial sediments was inferred to be the Weddell Sea region. Sediment input from the Weddell Sea was reduced during glacial periods by extensive ice sheets and weakened current from the Weddell Sea. Sediment supply from the Weddell Sea increased during interglacial periods, especially those with higher warmth such as MIS 5, 9, and 11. This suggests that the influence of deep water from the Weddell Sea increases during interglacial periods and decreases during glacial periods, with the degree of influence increasing as interglacial intensity increases.

Background: Suicide is a major public health concern. The elderly have the highest rate of suicide and they make more lethal suicide attempts and have fewer psychiatric interventions than young people. Furthermore, they have old-age specific psychosocial difficulties. The present study investigated psychosocial risk factors and characteristics of an index suicide attempt of the elderly suicide attempters.

Methods: Subjects included 388 patients who were admitted to the emergency room following self-poisoning. Two age groups were defined: younger patients (aged less than 65 years) and older patients (aged over 65 years). Data including demographic factors, suicidal risk factors and information about the current suicide attempt were obtained from a retrospective chart review.

Results: The number of suicide attempters over the age of 65 years old was 57, and their mean age was 73.5 ± 7.5 years. The elderly patients had more underlying medical illnesses than the under-65 group (p < 0.001). Depression was the most common psychiatric diagnosis. Psychotropics were the most commonly ingested drugs in both groups, but the use of pesticides was more notable in the elderly. The elderly suicide attempters had higher risk-rating scores (p < 0.001) and lower rescue-rating scores (p = 0.014) than the under-65 group. Male-to-female ratio of the elderly group was nearly 1:1 unlike the under-65 group (p = 0.004).

Conclusion: Elderly suicide attempters had different psychosocial stressors such as physical illness and more lethal suicide attempts. Our study suggests the need for development of specific preventive strategies and management guidelines for the elderly suicide attempters.

The diatoms are an ecologically important group of algae that have been extensively studied by ecologists and taxonomists. However, the large-scale patterns of diatom distribution and the factors underlying this distribution are largely unknown. The aims of this study were to identify the large-scale spatial patterns of benthic diatom assemblages in Korean streams and rivers, and to assess the importance of numerous environmental factors on diatom distribution. We classified 720 study sites based on diatom flora. Benthic diatoms, water chemistry, altitude, and riparian land cover and use were characterized by multivariate analyses, Monte Carlo permutation tests, and indicator species analysis. In total, we identified 531 diatom taxa. Diatom assemblages were mostly dominated by species of the genera Achnanthes, Navicula, Nitzschia, Cocconeis, Fragilaria (Synedra included), Cymbella, Gomphonema, and Melosira. Cluster analysis partitioned all 720 sites into eight groups based on diatom species composition. Canonical correspondence analysis indicated that altitude, land cover and use, current velocity, electrical conductivity, and nutrient levels explained a significant amount of the variation in the composition of assemblages of benthic diatoms. At the national scale, a downstream ecological gradient was apparent, from fast-flowing, mostly oligotrophic highland streams to slow-flowing, mostly eutrophic lowland rivers. Our data suggest that spatial factors explain some of the variation in diatom distribution. The present investigation of the spatial patterns of benthic diatoms, the ecological determinants of diatom occurrence, and the identification of diatom indicator species contributes to development of a program for assessing the biological integrity of lotic ecosystems in Korea.